Shin Splints

Shin splints, is a generic label used to describe shin pain; a more common medical term is medial tibial stress syndrome

The Anatomy

There are two key structures that, involved in ‘Shin Splints’:

1. Tibialis anterior

2. Tibialis posterior

Commonly other muscles are affected: (These other muscles become entrapped by the scar tissue of either the tib anterior, or tib posterior. This creates a ‘compartment syndrome’ which increases the pain)

-         Gastrocnemius

-         Soleus,

-         Extensor muscles

If the tib anterior is weaker than the tib posterior or visa versa you get localized shin pain. The key is to identify which structure is tight and stretch it. Also the other structure, which is over stretched, needs to be strengthened.

Each case is unique, however in my experience the tib posterior is usually the weaker structure.

The two most common mechanisms that create shin pain are overuse and stress fractures.

Overuse:

Inadequate recovery is the key problem. Combinations of scar tissue build up in the muscles on the front of the shin and deep in the calf, leads to accumulated scar tissue. This accumulation can cause shin pain, as well as lead to muscle imbalances, over-pronation, or other biomechanical problems.

There are many training variables which increase the likelihood of ‘shin splints’

- running surface

- shoes

- intensity

- workout type

- hills

For example, running on cement with worn out shoes creates more stress on your body than running on a trail with newer shoes. The repeated pounding of the running cycle results in muscle fatigue and overuse, leading to higher forces applied to the leg’s muscles and bones.

Stress Fracture:

Shin splints can be confused with stress fractures because pain is often in the same location. Stress fractures occur when load on the bone causes it to break down faster than it can rebuild. This usually happens with high mileage, especially if mileage increases too rapidly. Low mileage can also cause stress fractures when there are other problems involved. These problems can be existing scar tissue in the surrounding muscles. Dietary deficiencies and metabolic disorders also lead to stress fractures in low mileage situations.